Résumé
Objective@#To assess and analyze clinical nursing workload of tertiary general hospitals in Tianjin.@*Methods@#4 tertiary general hospitals in Tianjin were recruited by convenience sampling. 13 representative departments of the medical system and the surgical system were selected as the investigation departments. All the clinical duty nurses of every day work in selected departments were taken as the observation objects. Unified training investigators used work sampling method to observe and record the "operation" , "movement", "waiting" and "others" four types of activities of nurses, taking an observation point in a minute; SPSS17.0 was used for analysis.@*Results@#Totally 172 800 sampling points were selected. Besides 2.62% (4 534/172 800) of other affairs, the total nursing workload in one day was 97.38% (168 264/272800), with 85.03% (146 923/172 800) operating time including direct nursing accounting for 33.64% (58 144/172 800), indirect nursing accounting for 8.92% (15 422/172 800), and 42.46% (73 363/172 800) of related nursing. Movement accounted for 11.71% (20 228/172 800), while waiting accounted for 0.65% (1 113/172 800).@*Conclusion@#Generally, nurses in tertiary general hospitals have long working time and heavy workload, but direct nursing which can reflects the value and connotation of nursing work is low. In nursing work, the "waiting" caused by the lack of personnel, material, equipment, environment problems made a waste of time and human resources to certain extent. Therefore, results of the present study can provide reference for tertiary hospitals to optimize the allocation of nursing human resources, improve the quality of nursing service, reduce the workload of nurses and construct lean management system.
Résumé
Objective To quantify the workload rate of nurses at clinical departments and to clarify the current situation of clinical nursing work. Methods We randomly selected three departments respectively from the medical system and the surgery system as observation areas, and the nurses on the job as observation objects. Then we drew up the to-do-list of nursing work, and defined the concepts and activities of various items. The nurses of the department were observed and recorded every 5 minutes by uniformly-trained observers, and the data were collected and entered into the Excel software to set up the database by using the method of work sampling combined with the random starting point and other time intervals. Based on data collation and analysis of SPSS19. 0 statistical software, the improvement and control scheme was put forward. Results The average nursing workload rates of medicine and surgical systems were 93. 52％ and 92. 13％ respectively. Direct nursing in the surgical system accounted for 10. 59％, and indirect nursing accounted for 62. 89％; direct nursing for the medical system accounted for 16. 20％ and indirect nursing for 57. 32％. The proportions of nursing work belonged to operation increment were relatively large (77. 32％ and 81. 54％). Conclusions The work sampling method is more comprehensive and objective to reflect the intensity of nursing workload. To define the workload of clinical nurses and distinguish the increment and waste items of nursing process are helpful to improve the quality of nursing management and the efficiency of service.
Résumé
A amostragem do trabalho é um método para o estudo do tempo, que se baseia em observações intermitentes, instantâneas e casuais de atividades de um trabalhador, com o objetivo de determinar como é gasto o tempo em uma jornada de trabalho. Na presente pesquisa, a autora analisa o referencial teórico sobre o método amostragem do trabalho, para o estudo do tempo no trabalho da enfermagem e constrói um instrumento de classificação de atividades de enfermagem, para a aplicação do referido método, com o intuito de mensurar o tempo despendido no trabalho da enfermagem, em instituições hospitalares. Para analisar o referencial teórico, foi realizado um levantamento bibliográfico em base de dados internacionais para publicações científicas e da área da saúde. Para compor o instrumento de classificação de atividades de enfermagem, foram consideradas oito categorias de atividades: cuidados diretos de enfermagem, cuidados indiretos de enfermagem, comunicação, documentação, atividades relacionadas à unidade, tempo pessoal, tempo de espera e outras atividades. Portanto, a autora espera contribuir com uma ferramenta para o estudo do tempo no trabalho da enfermagem.
Work sampling is a method for performing time studies, based on intermittent, instant, and random observations of a worker's activities, with the goal of determining how time is spent during a work shift. In the present research, the author analyzes the theoretical aspects of the work sampling method for time study in nursing, and builds a tool for the classification of nursing activities for the application of said method, with the intention of measuring how time is spent in nursing at hospitals. For the analysis of the theoretical aspects a bibliographical search has been conducted on international data bases of scientific and health care publications. For the development of the tool for the classification of nursing activities, eight categories have been considered: direct nursing care, indirect nursing care, communication, documentation, unit-related activities, personal time, waiting time, and other activities. Therefore, the author hopes to contribute with a tool that enables time study in nursing.